Low blood pressure is not “a trivial matter”

Teacher Zhao squatted on the ground two days ago to pick up leeks. When he stood up, his eyes suddenly turned black. If he hadn’t supported his daughter, he would have fallen. The doctor at the hospital said that his blood pressure was a little low: 80 / 60mmHg. He also said a lot of the dangers of hypotension And even said that there is still danger to life. So Mr. Zhao called to inquire: such a trivial matter as low blood pressure can cause sudden death?

Answer: Yes. However, hypotension is not a trivial matter, and patients’ friends still need to fully understand and value it.

What is hypotension?
Hypotension is a general term for systemic arterial pressure below normal. Generally speaking, when the upper limb blood pressure of an adult is measured below 90 / 60mmHg (12.0 / 0.8Kpa) according to the conventional measurement method, it can be called hypotension.

Hypotension can be roughly divided into physiological hypotension and pathological hypotension.

Physiological hypotension refers to some healthy people, whose blood pressure measurement has reached the standard of hypotension, but without any symptoms, and for a long time, the organs of the system have not suffered from ischemia and hypoxia. In addition to the decrease in blood pressure, pathological hypotension is often accompanied by different degrees of symptoms and certain diseases. Like hypertension, hypotension is divided into primary hypotension and secondary hypotension. Hypotension without any cause of disease is called primary hypotension. Hypotension caused by certain diseases is called secondary hypotension.

There are many conditions that can cause hypotension: insufficient blood volume, such as blood loss or diarrhea, and vomiting; insufficient pumping of the heart, such as bradycardia or heart failure.

Five common conditions of hypotension in the elderly:
(1) Drug-induced hypotension: The elderly often have multiple complications and take more drugs. Methyldopa, guanethidine, and uridine are among the antihypertensive drugs (these drugs are relatively small in clinical practice). Application); Psychotropic drugs such as chlorpromazine, perphenazine, etc .; Diuretics such as dihydroglucuronide, furosemide, etc., and antianginal drugs such as analgesia, nitroglycerin, etc .; can cause hypotension.

(II) Orthostatic hypotension: The elderly have poor neuroregulatory function, decreased arterial elasticity during arteriosclerosis, and abnormal blood pressure regulation when their posture is changed. Patients who are weak, prolonged in the prone position, or in the squatting position, who have been standing in a sweltering environment for too long, are likely to induce orthostatic hypotension.

(3) Urinary hypotension: Due to the sudden emptying of the bladder at night, the abdomen pressure suddenly decreases, the veins expand, the blood volume in the heart decreases, and the blood pressure decreases. This condition is more likely to occur in older men when they wake up at night and urinate.

(4) Low blood pressure in summer: The temperature in summer is high, the human body sweats, and the person who sweats a lot can sweat, which can reach the amount of water discharged by taking a diuretic every day. Excessive sweating can cause a reduction in blood volume. At the same time, under the high temperature in summer, the body’s surface blood vessels dilate, vascular resistance decreases, and blood pressure decreases accordingly.

(V) Postprandial hypotension: It usually occurs in the elderly, and the prominent manifestation is that the systolic blood pressure is lower than normal by 20mmHg 30 to 60 minutes after a meal, and returns to normal after 2 to 3 hours. About 1 hour after a meal with the lowest blood pressure, symptoms of dizziness and light footsteps are prone to occur. The blood volume of the brain is significantly reduced, which is prone to drowsiness and loss of mind. This is because after the food enters the stomach, the digestive tract will secrete the digestive hormone enterokinase, which increases the blood flow in the abdomen and dilates the blood vessels in the whole body, resulting in a decrease in blood return to the heart and a decrease in blood pressure. Under normal circumstances, when the brain detects changes in the body, it will make the heart beat faster, increase blood vessel constriction, and increase blood pressure to normal levels. However, if the autonomic nerve is abnormal and the body is not sensitive to changes in the body, postprandial hypotension is likely to occur.

In addition, some acute and severe diseases such as anaphylactic shock, and some nervous and endocrine system abnormalities may also cause hypotension.

What are the symptoms and harms of hypotension?
Hypotension may be transient or long-term. The harm of hypotension is caused by insufficient blood supply to various organs of the human body, slow blood circulation, ischemia of distal capillaries, affecting the supply of oxygen and nutrients to tissue cells, and Excretion of carbon dioxide and metabolic waste. Because the brain is extremely sensitive to ischemia and hypoxia, the ischemic damage caused by hypotension to brain tissue is extremely prominent. Hypotension easily induces ischemic stroke, angina pectoris, myocardial infarction and other emergencies. Specifically, it is divided into the following 7 categories:

(1) Symptoms of fainting may occur during sudden and severe hypotension. Sudden fainting and fall easily cause trauma such as fracture.

(B) The study found that severe hypotension may cause cerebral infarction and sudden cardiac death. After the orthostatic hypotension is severe, the patient’s blood pressure drops rapidly and syncope occurs every time he changes position, so that he is forced to stay in bed, which brings a serious burden to the patient, family and society.

(3) Patients with hypotension can cause angina pectoris. This condition is not only seen in patients with low blood pressure and coronary heart disease, but also due to low blood pressure itself resulting in insufficient coronary blood supply, causing myocardial hypoxia and ischemia to produce the above symptoms.

(4) Dizziness, headache, loss of appetite, fatigue, fatigue, indigestion, motion sickness, seasickness, malaise, loss of memory, and decreased work ability are common in hypotension.

(5) Patients with long-term hypotension are likely to cause depression and prone to depression.

(6) People with severe hypotension will experience hearing loss and blurred vision. According to research, hypotension greatly increases the incidence of senile dementia.

(7) Endocrine dysfunction will occur in patients with hypotension. Mainly manifested in the lack of substances such as epinephrine and norepinephrine, some patients with reduced blood sugar and sexual function decline.

What should I do if hypotension occurs?
First, physiological hypotension does not require treatment.

Second, patients with primary hypotension do not advocate treatment with drugs, and most of them can be improved through the adjustment of daily life. Such as avoiding insomnia, drinking too little water, partial eclipse, nervousness and other incentives.

If it is a transient drop in blood pressure, it is recommended to immediately change position and take a sitting or lying position. Simple actions can be taken to avoid loss of consciousness: crossing your legs, pressing on abdominal muscles, increasing blood pressure by squeezing leg veins (venous blood in the legs to the heart) and stimulating the nervous system to constrict arteries (increasing hypertension). Replenish blood volume, such as drinking 2 to 3 glasses of water. Call 120 and go to the hospital in time to clarify the cause of hypotension, eliminate organic diseases early, and actively treat the primary disease.

If you have symptoms of hypotension or your blood pressure is often low, you can reduce one by taking multiple antihypertensive drugs at the same time. If a drug is originally supported, it can be reduced. It is worth noting that patients who take multiple antihypertensive drugs should never stop all antihypertensive drugs at once, and they should be reduced or stopped under the guidance of a doctor.

Special Note:
Hypotension prevention and self-monitoring measures

1. Persist in doing a daily self-check of blood pressure. The systolic blood pressure of elderly patients with hypertension should not be lower than 130mmHg.

2. Patients with good blood pressure control should go to the hospital to adjust their medication in time in the summer.

3. In the hot and sweaty summer, you should replenish water and salt.

4. Weak people should strengthen nutrition.

5. After getting up, sitting, and squatting, change your posture slowly. Pay attention to the slow movement to avoid changing your posture too quickly and standing for a long time.

6. Pay attention to ensure sufficient sleep time, the pillow cushion height should be 15 cm when sleeping.

7. It is best not to go to the toilet at night, and have a bedpan or accompanied by someone in case of accident.

8. Strengthen physical exercise. Physical exercise has a regulating effect on hypertension and hypotension. The elderly with low blood pressure can choose the exercise program that suits them according to their physical condition, which can be Tai Chi, walking and jogging.

9. When preparing meals for the elderly, it is important to understand postprandial hypotension and make reasonable meals based on this. You should rest for a while after meals, and should not move immediately to avoid accidents.

10. All patients with hypotension should go to the hospital for treatment, and it is better not to go out alone.

11. Note that it is not recommended to take a hot bath for a long time. The temperature of the bath water should not be too high, especially in the bath. The blood vessels in the whole body are dilated to varying degrees, which can further reduce blood pressure. Also, it is not advisable to take a bath when hungry.

12. Drinking can dilate blood vessels, so it should be listed as a contraindication for patients.